scholarly journals Neutrophil-to-lymphocyte Ratio and Platelet-to-lymphocyte Ratio Correlations with C-reactive Protein and Erythrocyte Sedimentation Rate in Traumatic Brain Injury

2020 ◽  
Vol 8 (B) ◽  
pp. 1185-1192
Author(s):  
Gede Febby Pratama Kusuma ◽  
Sri Maliawan ◽  
Tjokorda Gde Bagus Mahadewa ◽  
Tjokorda Gde Agung Senapathi ◽  
Anak Agung Wiradewi Lestari ◽  
...  

BACKGROUND: Immune system and inflammatory response play an essential role in the development of secondary brain injury (SBI) after traumatic brain injury (TBI). An inflammatory biomarker that can reflect the SBI severity is needed to increase the effectivity of TBI management and prevent morbidity and mortality post-TBI. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), which are more affordable than C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), theoretically have the potential to be used as a marker of the SBI severity. However, NLR and PLR in daily medical practice are not yet fully utilized. AIM: The aim of the study was to correlate NLR and PLR with CRP and ESR as a marker of SBI severity post-TBI. METHODS: This cross-sectional study was conducted at Sanglah Hospital Denpasar from January to April 2020. Patients diagnosed with TBI were included in this study by consecutive sampling. The blood samples were taken at 24-h post-TBI to obtain the NLR, PLR, CRP, and ESR results. Spearman’s correlation test was conducted to determine the correlation between NLR and PLR with CRP and ESR. RESULTS: Eighty-five patients were included in data analysis. Median ± (interquartile range) of the NLR, PLR, CRP, and ESR were 7.60 ± (6.83), 145.58 ± (76.95), 60.83 ± (66.3), and 12.50 ± (13.85) consecutively. NLR and PLR had a significant positive correlation with CRP (r = 0.472, **p < 0.01; r = 0.283, **p < 0.01 consecutively). But, NLR and PLR were not correlated with ESR. CONCLUSION: NLR and PLR can become a useful and more affordable marker for reflecting the SBI severity in acute TBI.

2021 ◽  
Vol 9 (F) ◽  
pp. 574-583
Author(s):  
Tjokorda Istri Sri Dalem Natakusuma ◽  
Tjokorda Gde Bagus Mahadewa ◽  
Putu Eka Mardhika ◽  
Sri Maliawan ◽  
Tjokorda Gde Agung Senapathi ◽  
...  

BACKGROUND: Secondary traumatic brain injury (TBI) is injury to the brain following primary TBI because of neuroinflammation as consequences of neuronal and glial cell injury which cause release of various inflammation cytokine and chemokine. Biomarker examination to predict the severity of secondary TBI is important to provide appropriate treatment to the patient. This article reviews possibility several common laboratory parameter such as monocyte-to-lymphocyte ratio (MLR), mean platelet volume-to-platelet count (PC) ratio (MPV-PCR), c-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) to predict severity of secondary TBI. LITERATURE REVIEW: TBI activates microglia which increase infiltration and proliferation of monocyte. Neuroinflammation also increases thrombopoiesis which leads to increase megakaryocytes production. In the other hand, due to disruption of brain blood vessels because of trauma, coagulation cascade is also activated and leads to consumptive coagulopathy. These are reflected as high monocyte count, low PC, and high MPV. Lymphocyte count is reported low in TBI especially in poor outcome patients. CRP is an acute phase reactant that increased in inflammation condition. In TBI, increased production of Interleukin-6 leads to increase CRP production. In head injured patients, ESR level does not increase significantly in the acute phase of inflammation but last longer when compared to CRP. CONCLUSION: MLR, MPV-PCR, CRP, and ESR could be predictor of severity in secondary TBI.


2021 ◽  
pp. 1-7
Author(s):  
Zahra Soleimani ◽  
Fatemeh Amighi ◽  
Zarichehr Vakili ◽  
Mansooreh Momen-Heravi ◽  
Seyyed Alireza Moravveji

BACKGROUND: The diagnosis of osteomyelitis is a key step of diabetic foot management. Procalcitonin (PCT) is a novel infection marker. This study aimed to investigate the diagnostic value of procalcitonin and other conventional infection markers and clinical findings in diagnosis of osteomyelitis in diabetic foot patients. METHODS AND MATERIALS: This diagnostic value study was carried out on ninety patients with diabetic infected foot ulcers admitted in Kashan Beheshti Hospital, 2016. After obtaining consent, 10 cc blood sample was taken for measuring serum PCT, CBC, ESR, CRP and FBS. Clinical characteristics of the wounds were noted. Magnetic resonance imaging of the foot was performed in all patients to diagnose osteomyelitis. All statistical analyses were done with the use of SPSS-16. RESULTS: PCT levels were 0.13 ± 0.02 ng/mili patients with osteomyelitis (n= 45) and 0.04 ± 0.02 ng/ml in patients without osteomyelitis (n= 45). PCT, Erythrocyte sedimentation rate and C-reactive protein was found significantly higher in patients with osteomyelitis (p< 0.001). The ROC curve was calculated for PCT. The area under the ROC curve for infection identification was 1 (p< 0.001). The best cut-off value for PCT was 0.085 ng/ml. Sensitivity, specificity, and positive and negative predictive values were 100%, 97.8%,97.8% and 100%, respectively. CONCLUSION: In this group of patients, PCT was useful to discriminate patients with bone infection. Also, Erythrocyte sedimentation rate and C-reactive protein can be used as a marker of osteomyelitis in diabetic patients.


Author(s):  
Hasan Hüseyin Özdemir ◽  
Ahmet Dönder

Abstract Objectives A tension headache is the most common type of headache, and its causes are multifactorial. A relationship has been shown between migraine headaches and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP). In this study, we investigated the NLR, PLR, and serum CRP levels in frequent episodic tension-type headache (FETTH) and chronic tension-type headache (CTTH) patients. Materials and Methods This retrospective study included 64 patients with FETTH, 80 patients with CTTH, and 60 healthy controls who were followed up in the neurology clinic. Hematological parameters were compared between the patient and control groups. Results In CTTH patients, platelets, NLR, PLR, and CRP values were statistically higher than in FETTH patients and patients in the control group. In FETTH patients, the PLR value was higher than in patients in the control group, but there was no statistically significant difference in NLR and CRP values between FETTH patients and patients in the control group. Also, there was no correlation between these values and age and gender. Conclusion Increase platelet count might have an effect on tension-type headache pathophysiology. Systemic inflammation parameters were shown to be significantly higher in CTTH patients. More comprehensive studies are needed to evaluate the effect of systemic inflammation on the chronicity of tension headaches.


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